Both open and endoscopic surgical procedures often require sutures to ligate, join or otherwise treat tissue. Generally, suture needles with attached suture strands are grasped either manually or by forceps and passed through the desired work site so a knot can be tied. While the procedures are fairly uncomplicated in open surgery where most suture sites are readily accessible, in endoscopic procedures, where access to the work site is not readily available, the surgeon must use auxiliary devices to be able to grasp the suture strands and pass them through desired tissue.
Various instruments and techniques have been developed for surgical repairs requiring the passing of sutures to distant locations. For example, U.S. Pat. No. 4,781,190 to Lee discloses a two-ended needle enabling arthroscopic suturing of the interior of a joint. The two-ended needle of U.S. Pat. No. 4,781,190 may be either straight or curved and is provided with an eyelet intermediate the ends of the needle. The suture is passed through the eyelet of the needle and then through the tissue by alternately passing the ends of the needle through the tissue to be sutured. U.S. Pat. No. 4,441,497 to Paudler also discloses a suture passer having a plurality of flexible elongated members joined at their corresponding ends, the ends being sharpened enough to pass through desired tissue sites. Pushing the ends toward each other opens up spaces between the members into which one or more sutures may be placed. Moving the ends of the flexible members away from each other closes up the spaces to grip the sutures so that the ends of the flexible members and, consequently, the sutures, may be passed through desired suture sites.
Another device for advancing suture directly to a work site is described in U.S. Pat. No. 4,890,615 to Caspari et al., according to which a suture strand is advanced using a roller mechanism to feed the suture through a hollow needle at the end of an elongated tube into the tissue to be sutured. While suitable for mono-filament suture, such roller-type devices may unravel and disentangle multi-stranded suture.
Accordingly, there is a need for an improved suture passing instrument that overcomes the disadvantages of the prior art. A method of driving a length of suture through tissue to allow a stitch to be tied without removing a needle from the suture is also needed.